William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What are the symptoms of premature ejaculation?

Generally, premature ejaculators will only have about a minute or less of intravaginal time before they ejaculate.

Retarded ejaculation will present as a long delay of intravaginal time to the point where the patient will not be satisfied with the sexual relation.

Anejaculation or retrograde ejaculation is the experience of a dry orgasm. The semen doesn't go out of the urethra. It can either flow to the bladder instead or not be produced at all. Following the sexual act in the latter case, patients will notice the presence of semen in their first urine.

What is the treatment for premature ejaculation?

The treatment will vary according to the cause of premature ejaculation. Couples sexual therapy or psychological therapy can be useful when psychological causes are involved. Other nonpharmacological therapies include actively trying to "hold it in." Drug therapy has also proven to be successful. The medications used to treat premature ejaculation are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).

What is disordered orgasm?

Disordered orgasm is the inability to reach an orgasm after adequate stimulation. Orgasm is still a phenomenon that is poorly understood.